Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

Assessment of Parenting Practices Related to Conduct Problems: Development and Validation of the Management of Children's Behavior Scale

We report on the development and initial validation of the parent-report scale, Management of Children's Behavior Scale (MCBS), designed to evaluate parenting practices related to conduct problems in children. Children (N=396, ages 2-14) referred for outpatient treatment and their parents served as participants. We evaluated the composition and consistency of the scale and provided evidence pertaining to concurrent, predictive, and incremental validity. Evidence for each type of validity was consistent with the conceptualization of the scale and the pertinence to child conduct problems. The measure also was sensitive to therapeutic changes. Parenting practices targeted in treatment (parent management training) improved as predicted over time. The results suggest the measure may be useful in evaluating parenting practices known to relate to conduct problems and often targeted for intervention in parent- and family-based treatment.     

The norms and stability of new measures of the multidimensional body image construct

The measurement of the body image construct has become increasingly multidimensional. New assessments are available to measure various facets of body image functioning: The Body Image Disturbance Questionnaire, Appearance Schemas Inventory-Revised, Body Image Coping Strategies Inventory, and Body Image Quality of Life Inventory. The present article reports normative data and acceptable internal reliabilities across seven completed investigations using these measures with female and male college students. Sex differences were examined and found, as expected, for most of the measures. In addition, a study evaluated an undetermined but essential psychometric property of these facets of the construct—their test–retest reliability. In a sample of 107 college students, the 2-week stability of these measures was found to be acceptable. Several directions for future research with these assessments are identified.     

A Comparison of Results and Acceptability of Functional Behavioral Assessment Procedures with a Group of Middle School Students with Emotional/Behavioral Disorders (E/BD)

There is currently controversy over the validity and applicability of functional behavioral assessment (FBA) procedures with students with emotional/behavioral disorders (E/BD). A set of FBA procedures, including teacher and student interviews and direct classroom observations, were carried out with eight students with disabilities (7 classified E/BD, one classified LD). Results indicated that when all three methods (teacher/student interviews, classroom observations) yielded a ranking for a function they agreed 64% of those occasions. For those situations in which there was overall disagreement there was agreement between teacher interview and classroom observations most of the time. Social validity data indicated that both students and teachers felt that the assessment procedures were a useful and productive process.     

State of Multicultural Neuropsychological Assessment in Children: Current Research Issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.     

Emotional competence in children with autism: Diagnostic criteria and empirical evidence

The diagnostic criteria of autism spectrum disorders (ASD) include emotional impairments. However, scientific evidence for these impairments is varied and subtle. In this contribution, recent empirical studies that examined the emotional competence in children and adolescents with ASD are reviewed. Four aspects of emotional competence that are important to children’s daily social functioning (expression, perception, responding, and understanding) are discussed, differentiating between mentally retarded and normally intelligent children and adolescents with and without ASD in natural and structured contexts. On various accounts, the emotional impairments of children with ASD that are found in scientific studies provide a more differentiated view on the impairments suggested by the diagnostic literature. Consistent empirical findings and gaps in the field are discussed. Theoretical and clinical recommendations for assessment procedures are suggested.     

The pain behavior scale: Modification and validation for outpatient use

The present study investigated the validity of an inpatient pain behavior rating scale modified for outpatient use. A series of 43 consecutive outpatients referred for evaluation of chronic pain was examined using the Pain Behavior Scale (PBS) and other psychometric instruments. Analyses revealed significantly higher Pain Behavior Scale scores for low back and multiple pain-site groups. The results also indicated a high degree of internal consistency of the scale. A multiple regression analysis, predicting observed pain behavior from reported pain behavior, indicated that decreased activity accounted for 32% of the variance in the PBS score. A similar regression for pain experience found that the pain level and the sensory scale score on the McGill Pain Questionnaire accounted for 39% of the PBS variance. Psychological characteristics including disease conviction, self-control, depression, and anxiety explained 45% of the variability in the PBS score. Thus, the scale is related to pain intensity, interference with activities, and a variety of psychological characteristics. The scale provides a measure of observable pain behavior that is also relatively independent of these clinical data sources. The Pain Behavior Scale as modified for outpatient use provides a brief index of pain behavior with potential use in the comprehensive evaluation of the pain patient.     

Conversational skill and locus of perception

The present study attempted to identify behavioral skills associated with global perceptions of communication competence and to determine if the relationship between competence and skills varies as a function of perceptual locus. Fifteen dyadic conversations were videotaped. Each interactant rated self and partner and was rated by four observers who viewed each tape. Results indicated that subjects' perceptions of their partners' skills accounted for 87% of the variance in subjects' ratings of partners' competence and 80% of the variance in subjects'self-perceived confirmation. Observers' ratings of subjects' skills predicted 83% of the variance in observers' ratings of subjects' competence. Observers'ratings of subjects'skills were unrelated to subjects' self-rated competence.     

Are Our Concepts conscious state and conscious creature Vague?

Intuitively it has seemed to many that our concepts conscious state and conscious creature are sharp rather than vague, that they can have no borderline cases. On the other hand, many who take conscious states to be identical to, or realized by, complex physical states are committed to the vagueness of those concepts. In the paper I argue that conscious state and conscious creature are sharp by presenting four necessary conditions for conceiving borderline cases in general, and showing that some of those conditions cannot be met with conscious state. I conclude that conscious state is sharp, and the conclusion is then extended to conscious creature. The paper ends with a brief discussion of some implications.